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ELECTRICAL PERMIT APPLiCA�'ION <br />CITY OF EVERETT PERMIT SERVICES <br />425-257� 810 DAFAX 425-257 8857 Twww ve?ett�,va.org /�'-� b�/ Z Z <br />�� �Z—/y <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />� ii l� �;<��� oi<� t -tL t <br />PROJECT ADDRESS <br />���-}1;Iv1S ���Y,lS �i�L�tt��e- _�1�L <br />OWnef MailAddress <br />tv��(��� 1��-• �)i1�)`Uj <br />Ciry S�ate2ip Phone <br />Tenanl Ma�lAddress C�ty Stale/Zip Phone <br />��1�� -ICi`V�� Il�d`l `jJ.51 )�" ���uE�l•�ii� ln,'r'� ������ �I��j3SIJ.7S <br />C-IeclricalContraclor Mad�ddress C�ty Stale2ip Phona <br />il:i�:el '''I.}r�� <br />State License Number <br />�:;,, ���� ��I � <br />� Proposed Use o( Building <br />I <br />I I l i �' <br />�i Square Footage Qf rasidential new conslruction, rernodel or addition) <br />I�escription of Work l0 13a Done: �'� � r "� I � �' �' �� �� ��'�'r � � ��'E� ! <br />tJOTE WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />E3E IN Rl10EWAYS, MC OR AC C�[3LE. <br />; CITY OF EVEFETT LOCAL SALES TA% CODE IS J105 <br />! hmeby cciirly thaf I h�vo rcnd and crarninel this applic� <br />� � ancct. All piovisions o//a�vs and ordin�nces govemmg <br />� .�. hvfhr,r specilicd hercin or noL Thu granfing ar a pennd <br />' : rolatn orcancel fhe pravisions o/any utherslate or local <br />per/onnance o/conslruclion. That 1 arn authorizerl by fhe <br />.: uik lor �vhich application is mada and I conrply wi(h Uio <br />;'9G 200 WAC. <br />�:P� . <br />�'I %`�C;�� `�� <br />Contract Prica ol Work <br />Contact Pe�son (Plan Reviee�) <br />�r�:�r- roer,s <br />�fron and know fhe samo (0 6o trua and <br />this (ypo o/ wo�k will bo conrple(ed <br />dues not �resmno fo givo aufhonty (o <br />la�v �e yuI ding construcfion a fho <br />awner ol thisPropeRy fo pedorm Iha <br />c���� Cnnfrar nr.c 1 a�v 1&.D RCW mid <br />i�/�,,I�� <br />